Academic outcomes before and after clinical onset of acquired demyelinating syndromes in children: a matched cohort data linkage study

It is unknown if cognition is impaired before clinical onset of paediatric acquired demyelinating syndromes. We conducted a matched cohort study using prospectively collected educational data in multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) patients ( n = 60) and controls (pooled n = 449,553). Academic performance at ages 10–11 was impaired in MOGAD (−1.27 adjusted z ‐score [95% CI: −1.81 to −0.73], P < 0.001) and preclinical MS (−0.40 [−0.80 to −0.0003], P = 0.0498). Moderate/high‐efficacy MS treatment was associated with better final academic performance (0.92 [0.28–1.57], P = 0.005). After clinical onset MS patients missed 8.7% of school (controls 2.9%, P < 0.001) and MOGAD patients 11.9% (controls 2.0%, P < 0.001).